Holzbach R T
Am J Med. 1976 Sep;61(3):367-76. doi: 10.1016/0002-9343(76)90374-0.
An integrative survey is given of three disease processes, in which recent progress of a fundamental nature has been made, primarily affecting the liver, either coincident with or caused by the gravid state. The three conditions considered include (1) recurrent cholestasis of pregnancy (RCP), (2) viral hepatitis coincident with pregnancy, and (3) acute fatty liver of pregnancy (AFLP). In addition to an assessment of our present knowledge with respect to RCP and AFLP, new genetic hypotheses are proposed. In the latter, the proposal of an ornithine transcarbamylase deficiency, similar to that seen in Reye's syndrome, has potential therapeutic implications that are explored. In light of the currently available information on the interaction between maternal viral hepatitis and the variant forms of vertical maternal-fetal transmission, tentative recommendations regarding management of the newborn are suggested.
本文综合概述了三种疾病过程,这些疾病在本质上取得了重大进展,主要影响肝脏,与妊娠状态同时发生或由妊娠引起。所考虑的三种情况包括:(1)妊娠复发性胆汁淤积症(RCP),(2)妊娠合并病毒性肝炎,以及(3)妊娠急性脂肪肝(AFLP)。除了评估我们目前对RCP和AFLP的了解外,还提出了新的遗传假说。在后者中,提出了类似于瑞氏综合征中所见的鸟氨酸转氨甲酰酶缺乏症,探讨了其潜在的治疗意义。根据目前关于母体病毒性肝炎与垂直母婴传播变异形式之间相互作用的现有信息,提出了关于新生儿管理的初步建议。